Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, United Kingdom.
Department of Physical- and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
PLoS One. 2024 Apr 4;19(4):e0298804. doi: 10.1371/journal.pone.0298804. eCollection 2024.
The aim was to compare the probability of discharge after hip fracture surgery conditional on being alive and in hospital between patients mobilised within and beyond 36-hours of surgery across groups defined by depression.
Data were taken from the National Hip Fracture Database and included patients 60 years of age or older who underwent hip fracture surgery in England and Wales between 2014 and 2016. The conditional probability of postsurgical live discharge was estimated for patients mobilised early and for patients mobilised late across groups with and without depression. The association between mobilisation timing and the conditional probability of live discharge were also estimated separately through adjusted generalized linear models.
Data were analysed for 116,274 patients. A diagnosis of depression was present in 8.31% patients. In those with depression, 7,412 (76.7%) patients mobilised early. In those without depression, 84,085 (78.9%) patients mobilised early. By day 30 after surgery, the adjusted odds ratio of discharge among those who mobilised early compared to late was 1.79 (95% CI: 1.56-2.05, p<0.001) and 1.92 (95% CI: 1.84-2.00, p<0.001) for those with and without depression, respectively.
A similar proportion of patients with depression mobilised early after hip fracture surgery when compared to those without a diagnosis of depression. The association between mobilisation timing and time to live discharge was observed for patients with and without depression.
本研究旨在比较手术 36 小时内和外开始活动的患者在存活且住院条件下髋部骨折手术后出院的可能性,这些患者分别来自不同抑郁分组。
数据来自英格兰和威尔士国家髋部骨折数据库,纳入 2014 年至 2016 年间接受髋部骨折手术且年龄在 60 岁及以上的患者。分别在有抑郁和无抑郁的分组内,估计手术 36 小时内和外开始活动的患者手术后存活出院的条件概率。还通过调整后的广义线性模型,分别估计活动时间与存活出院条件概率之间的关联。
共分析了 116274 例患者的数据。8.31%的患者被诊断为抑郁。在有抑郁的患者中,7412 例(76.7%)患者早期活动。在无抑郁的患者中,84085 例(78.9%)患者早期活动。手术后 30 天,与晚期活动相比,早期活动的患者出院的调整比值比为 1.79(95%CI:1.56-2.05,p<0.001)和 1.92(95%CI:1.84-2.00,p<0.001),分别在有和无抑郁的患者中。
与没有抑郁诊断的患者相比,有抑郁的患者在髋部骨折手术后早期活动的比例相似。活动时机与存活出院时间之间的关联在有和无抑郁的患者中均观察到。